Provider Demographics
NPI:1023200912
Name:FIRST CHOICE HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:FIRST CHOICE HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-517-1912
Mailing Address - Street 1:448 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4548
Mailing Address - Country:US
Mailing Address - Phone:786-517-1912
Mailing Address - Fax:786-517-1910
Practice Address - Street 1:448 E 9TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4548
Practice Address - Country:US
Practice Address - Phone:786-517-1912
Practice Address - Fax:786-517-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5289261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center